10 research outputs found
Teachers' Professional Identity in the Context of School-based Sexuality Education in Uganda - a Qualitative Study
School-based sexuality education makes teachers important gatekeepers of students’ access
to information about sexual and reproductive
health and rights. The school setting has the
potential to reach large numbers of students.
However, teachers’ professional identities may
go beyond, differ from or even conflict with the
qualities required of sexuality educators.
To gain a better understanding of the role of
professional identity in the delivery of schoolbased sexuality education, this study used
cultural schema theory to study teachers’ professional identities, and how these motivate
them to provide sexuality education. In-depth
interviews were conducted with 40 sexuality
education teachers at secondary schools in
Kampala, the capital of Uganda. Sexuality
education lessons were observed to validate the
findings from the interviews. Results identified
five cultural schemas of professional identity:
(i) upholder of ethics and regulations;
(ii) authority figure; (iii) counsellor and guide;
(iv) role model; and (v) guardian. The study
concludes that teachers’ cultural schemas of
professional identity motivate them to adhere
to moral discourses of abstinence and sexual
innocence. To support teachers in taking
more comprehensive approaches to sexuality
education, it is important that they receive
adequate teacher training and support from
the Ugandan government, the school
administration and the wider communit
Young people’s perceptions of relationships and sexual practices in the abstinence-only context of Uganda
The Ugandan government has been criticised on several grounds for its
abstinence-only policies on sexuality education directed towards young
people. These grounds include the failure to recognise the multiple
realities faced by young people, some of whom may already be sexually
active. In the study reported on this paper, students’ perceptions
of relationships and sexual practices were analysed to obtain an
understanding of how young people construct and negotiate their
sexual agency in the context of abstinence-only messages provided
in Ugandan secondary schools and at the wider community level. Ten
in-depth interviews and six focus group discussions were conducted
with students aged 15–19 years (N = 55) at an urban co-educational
secondary school. Data were transcribed verbatim and analysed using
grounded theory. Findings show that students engage in sexual activity
despite their belief that contraception is ineffective and their fears for
the consequences. Students’ age, gender, financial capital and perceived
sexual desire further increase risk and vulnerability. To improve their
effectiveness, school-based sexuality education programmes should
support students to challenge and negotiate structural factors such as
gender roles and sociocultural norms that influence sexual practices
and increase vulnerability and risk
Exploring Subjective Well-being in Older Age by Using Participant-generated Word Clouds
Purpose of the study: Previous research has overlooked the heterogeneity in older adults’ personal conceptions of subjective well-being (SWB), by not taking into account intradomain differences in the conceptions of SWB for different groups of
older adults. The aim of this article is therefore to explore (a) older adults’ own views on which aspects, categorized under
domains, are important to their SWB and (b) which domains and aspects are important to older adults in different contexts
and with different characteristics: to men and women, of different ages, and in different housing arrangements.
Design and methods: Sixty-six older adults (aged 65 and older) participated in our study. We asked the participants to
freely nominate aspects of SWB that are important to them, using participant-generated word clouds as our exploratory,
qualitative data collection method. The data were analyzed using qualitative inductive content analysis.
Results: We found 15 domains based on our participants’ conceptions of SWB. The multidimensional domains of social
life, activities, health, and space and place were most important to our participants. The domains and aspects were defined
and prioritized differently by different groups of participants.
Implications: SWB should be studied as a multidimensional, individualized, and contextualized process to generate meaningful
empirical information for researchers and policymakers
Occurrence of Pregnancies among HIV Infected Indian Women
This is the first study to examine the behavioural effect of HIV on fertility among HIV infected women in India. Retrospective calendar data from ever-married HIV infected women between 15 and 45 years of age, attending a specialized HIV clinic in Pune, Western India (N = 560), were analysed. Directly standardized overall and parity-specific pregnancy rates were compared among HIV infected women before and after coming to know about their HIV status. The age- and parity-standardized pregnancy rates and age-standardized parity-specific pregnancy rates were statistically significantly lower after knowing about HIV status as compared to before the HIV status was known. Analysis of parity-specific rates suggested lower likelihood of HIV infected women to progress to higher parity. The clear behavioural impact of HIV on fertility observed should be taken into account while estimating HIV infected pregnant women in the country. Ensuring access to information and services for PMTCT to HIV infected couples is essential to support informed reproductive decision making among them
Welbevinden: wat vinden ouderen er zelf van?
Subjectief welbevinden kan worden omschreven als iemands waardering van zijn of haar eigen leven.
Meer inzicht in het subjectieve welbevinden van ouderen is belangrijk omdat dit samengaat met een
betere ervaren en objectieve gezondheid. In onderzoek over welbevinden van ouderen wordt maar weinig
aandacht besteed aan de mening van ouderen zelf
"In a situation of rescuing life"
Background: Diabetes mellitus is an emerging public health problem in Tanzania. For the community and the
health system to respond adequately to this problem, it is important that we understand the meanings given to its
symptoms, and the care-seeking practices of individuals.
Methods: To explore collective views on the meanings given to diabetes symptoms, we conducted nine focus
group discussions with adult diabetes patients and members of the general community. To gain a better
understanding of how the meanings in the community inform the care-seeking practices of individuals, 19 in-depth
interviews were conducted with diabetes patients. The data were analyzed using principles of grounded theory and
applying cultural schema theory as a deductive framework.
Results: In the communities and among the patients, knowledge and awareness of diabetes are limited. Both
people with diabetes and community members referred to their prevailing cultural meaning systems and schemas
for infectious diseases to interpret and assign meaning to the emerging symptoms. Diabetes patients reported that
they had initially used anti-malarial medicines because they believed their symptoms—like headache, fever, and
tiredness—were suggestive of malaria. Schemas for body image informed the meaning given to diabetes symptoms
similar to those of HIV, like severe weight loss. Confusion among members of the community about the diabetes
symptoms instigated tension, causing patients to be mistrusted and stigmatized. The process of meaning-giving
and the diagnosis of the diabetes symptoms was challenging for both patients and health care professionals.
Diabetes patients reported being initially misdiagnosed and treated for other conditions by medical professionals.
The inability to assign meaning to the symptoms and determine their etiologies informed the decision made by
some patients to consult traditional healers, and to associate their symptoms with witchcraft causes.
Conclusion: The meanings given to diabetes symptoms and the care-seeking practices described in the study are
shaped by the prevailing cultural schemas for infectious diseases and their treatments. Efforts to educate people
about the symptoms of diabetes and to encourage them to seek out appropriate care should build on the prevailing
cultural meaning system and schemas for diseases, health and illness
Social capital and active membership in the Ghana National Health Insurance Scheme - a mixed method study
BACKGROUND: People’s decision to enroll in a health insurance scheme is determined by socio-cultural and socio-economic factors. On request of the National health Insurance Authority (NHIA) in Ghana, our study explores the influence of social relationships on people’s perceptions, behavior and decision making to enroll in the National Health Insurance Scheme. This social scheme, initiated in 2003, aims to realize accessible quality healthcare services for the entire population of Ghana. We look at relationships of trust and reciprocity between individuals in the communities (so called horizontal social capital) and between individuals and formal health institutions (called vertical social capital) in order to determine whether these two forms of social capital inhibit or facilitate enrolment of clients in the scheme. Results can support the NHIA in exploiting social capital to reach their objective and strengthen their policy and practice. METHOD: We conducted 20 individual- and seven key-informant interviews, 22 focus group discussions, two stakeholder meetings and a household survey, using a random sample of 1903 households from the catchment area of 64 primary healthcare facilities. The study took place in Greater Accra Region and Western Regions in Ghana between June 2011 and March 2012. RESULTS: While social developments and increased heterogeneity seem to reduce community solidarity in Ghana, social networks remain common in Ghana and are valued for their multiple benefits (i.e. reciprocal trust and support, information sharing, motivation, risk sharing). Trusting relations with healthcare and insurance providers are, according healthcare clients, based on providers’ clear communication, attitude, devotion, encouragement and reliability of services. Active membership of the NHIS is positive associated with community trust, trust in healthcare providers and trust in the NHIS (p-values are .009, .000 and .000 respectively). CONCLUSION: Social capital can motivate clients to enroll in health insurance. Fostering social capital through improving information provision to communities and engaging community groups in health care and NHIS services can facilitate peoples’ trust in these institutions and their active participation in the scheme